Head Injury CT Decision Rules
Decision rules answer whether to scan. Marshall and Rotterdam grade a scan that has been done. Paediatric and adult head-injury rules are not interchangeable, and a c-spine rule is not a head rule.
Educational reference for qualified professionals. Confirm the result against the source cited on the tool page and against local protocol.
Whether to image
Use the rule that matches the age and the body part. A positive decision rule is not a description of the injury.
- Canadian CT Head Rule (CCHR)Calculator
Canadian CT Head Rule for adults with minor head injury.
- PECARN Pediatric Head Injury RuleCalculator
PECARN for children. Not an adult rule with smaller numbers.
- NEXUS Cervical Spine CriteriaCalculator
NEXUS cervical-spine imaging criteria. A neck rule, not a head rule.
- Head injury in adultsVetting
Adult head-injury imaging pathway.
- Head injury in childrenVetting
Paediatric head-injury imaging pathway.
Grading the CT
These classifications describe findings on a CT that exists. They do not decide whether the CT was indicated.
Questions these pages get
Can I use the Canadian CT Head Rule for a child?
No. The Canadian CT Head Rule was derived in adults. PECARN is the paediatric head-injury rule on this site, and it is a different algorithm. The paediatric vetting guide is the pathway page.